Real-life impact of clinical metagenomics in the intensive care unit: a multicenter retrospective study in greater paris area hospitals
Authors' conclusion
In this real-life ICU cohort, mNGS identified additional pathogens in 25.8% of patients, deemed causative in 18 cases (13.6%), and a direct therapeutic impact was observed in 5.3% of cases.
Study context
- Population
- Critically ill patients with an metagenomic next-generation sequencing (mNGS) analysis requested from a microbiological sample, ten tertiary-care intensive care unit (ICUs), Greater Paris area, January 2018–April 2024144 mNGS analyses
- Participants
- 132 patients
- Outcome
- Microbiological yield and clinical impact of mNGS in routine ICU practice
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
- Samples with pathogens identified by mNGS
- 58 (40.3%)
- Additional pathogen identified by mNGS (of 132 patients)
- 34 (25.8%)
- Additional pathogen deemed causative
- 18 (13.6%)
- mNGS findings influenced therapeutic management
- seven patients (5.3%)
- Antibiotic de-escalation
- five
- Appropriate antibiotic escalation
- one
- Clinical decision support
- one
Observational data: associations, not effects.
Further findings
mNGS yield by sample type
- Pleural fluid
- n = 11/21, 52.4%
- Cerebrospinal fluid (CSF)
- n = 16/60, 26.6%
Pathogens detected exclusively by mNGS
- Of the 107 pathogens identified, detected exclusively by mNGS (notably anaerobic bacteria in pleural fluid and abscess samples)
- 43 (40.2%)
Original publication
Real-life impact of clinical metagenomics in the intensive care unit: a multicenter retrospective study in greater paris area hospitals. Crit Care. Published 8 January 2026. doi:10.
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